Summary of data respository for:

Alessio,Bindschadler, Busey, Shuman, Caldwell, Branch, Accuracy of Myocardial Blood Flow Estimation from Dynamic Contrast Enhanced Cardiac CT Compared to PET, 2019.




Contents:
1) tac_files/
Contains time attenuation curves for dynamic CT acquisitions.  Each file contains the input function curve, measured at the aorta, and the global myocardial TAC.

2) jsim_model_ctperfusion.proj
Project file for a jsim model to estimate myocardial blood flow from the files stored in tac_files/.  This model was used for all flow estimates in this paper.  The JSim application is freely available at:
https://www.physiome.org/jsim/

3) FlowEstimatesByPatient_Curated.xlsx
Table of flow estimates from PET and CT for all patients.




Abstract:
Background: The accuracy of absolute myocardial blood flow (MBF) from dynamic contrast enhanced cardiac CT (DCE-CT) acquisitions has not been fully characterized. We evaluate CT compared to Rb82 PET MBF estimates in a high-risk patient population.  Methods: In a prospective trial from 2014 to 2017, patients receiving clinically indicated Rb82 PET exams were recruited to receive a research DCE-CT exam.  The CT protocol included a rest and stress dynamic portion each acquiring 12-18 cardiac-gated frames and a CT coronary angiogram.  The global MBF was estimated from the PET exam using commercial software and from the CT exam using custom processing.  Results: 34 patients referred for cardiac rest-stress PET were recruited. Of the 68 DCE-CT scans, 5 were excluded due to injection errors or mismatched hemodynamics.  For the 63 successful studies, the CT derived global MBF were highly correlated with the PET MBF (r=0.92, p<0.001) with a mean difference of 0.7 ± 26.4%.  The CT MBF estimates were shown to be within 20% of PET estimates (p<0.02) with a mean: (a) MBF for resting flow of PET vs CT of 0.9 ± 0.3 vs 1.0 ± 0.2 ml/min/g; (b) MBF for stress flow of 2.1 ± 0.7 vs 2.0 ± 0.8 ml/min/g, and (c) myocardial flow reserve (MFR) (2.5 ± 0.6 vs 2.2 ± 0.6).  The proposed rest+stress+CTA protocol had a dose length product of 598±76 mGy*cm resulting in an approximate effective dose of 8.4±1.1 mSv.  Conclusion:  In a high-risk clinical population, a clinically practical DCE-CT provided unbiased absolute MBF estimates within 20% of Rb82 PET.  While unbiased, the CT estimates contain substantial variance a standard error of the estimate of 0.44 ml/min/g.  MFR estimation was biased with mean percent error of -13.6 ± 27.5%.

